In the County Court of ______ County, Nebraska
Total Page：16
File Type：pdf, Size：1020Kb
STATE OF NEBRASKA CASE NUMBER FORM NO. CC16:2.30 AFFIDAVIT OF SEX OFFENDER 01/2015 REV. REGISTRY SEARCH REQUIRED.
IN THE COUNTY COURT OF ______COUNTY, NEBRASKA
IN THE MATTER OF AFFIDAVIT OF SEX OFFENDER ______REGISTRY SEARCH Ward/Protected Person/ Incapacitated Person
I, ______, swear that I have completed the online search of the Nebraska
Sex Offender Registry for the proposed guardian or conservator as shown by the attached printouts of the
search page and results.
Date Signature
Name
Bar Number and Firm Name (attorneys only)
Street Address/P.O. Box
City/State/ZIP Code
Phone E-mail Address
State of ) ) ss. County of ) The foregoing instrument was acknowledged before me by , this Name day of , . Day Month Year
Notary Public (Signature of Person Taking Acknowledgment)
(Title or Rank) (Serial Number, if any)
CC 16:2.30 Page 1 of 2 My commission expires:
CC 16:2.30 Page 2 of 2